Centrelake Medical Group Inc

LBN: Centrelake Medical Group Inc
Centrelake Medical Group Inc is an health care organization with primary practice located at 1900 E La Palma Ave Ste D , Anaheim CA 92805-1647. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, which is considered as the primary health care specialty. Centrelake Medical Group Inc can be contacted via phone (909) 242-7300, or through Ceja, Tania via phone (909) 242-7300.

Contact Information

Primary practice address
1900 E La Palma Ave Ste D Anaheim CA 92805-1647
Phone: (909) 242-7300
Fax: (909) 784-3760
Website:
Map and Directions
Authorized official contact:
Name: Ceja, Tania
Phone: (909) 242-7300

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X

Profile Details

NPI number 1912572728
LBN Legal business name Centrelake Medical Group Inc
DBA Doing business as
Authorized official Ceja, Tania
Entity Organization
Organization subpart 1 No
Enumeration date May 24th, 2021
Last updated May 24th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912572728 NPPES
California MEDICAID GR0103950

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